Journal of Biology, Agriculture and Healthcare www.iiste.

org
ISSN 2224-3208 (Paper) ISSN 2225-093X (Online)
Vol.6, No.10, 2016

The Influence of Health Promotion on Behavior in Preventive and

Treatment of Pulmonary Tuberculosis on Prisoner Grade I of
Medan City
Naik Suryanta1* Soekidjo Notoatmodjo2 Gerry Silaban3
1.Public Health Department, Universitas Sumatera Utara, Medan (20154), Indonesia
2. Universitas Muh. Husni Thamrin, Jakarta

Abstract
Introduction Pulmonary tuberculosis is recognized a directly infectious disease resulted by Tuberculosis
bacterial (Mycobacterium tuberculosa). The prison Administration of Medan pointed out that for 3 years period
(2009-2011) got rising cases in Pulmonary of those prisoners. One of efforts to press down is by prevention and
overcome it on the prisoner is with a health promotion. Materials & Methodes :The objective of this study is to
know the affect of health promotion over the effort in prevention and the treatment of Pulmonary TB on
prisoners in Medan. On the preventive group, total sample of each group of intervention and control noted 158
people. On the treatment group, total sample of each group of intervention and control noted 58 people. In
taking the sample is by simple random sampling. The variable to measure such as knowledge, attitude and action.
The data was obtained by questionnaires that has been distributed before and after a health promotion held, then
data was analyzed using t-dependent test. Result : The result of study on preventive group indicated an
increasing score of knowledge found (p = 0.004), behave (p < 0.001), and action (p = <0.001) on the Pulmonary
TB prevention on intervention group compared to a control group (p = > 0.05). On the treatment group also
increasing score average of knowledge found (p = 0.017), attitude (p = < 0.001), and action (p = 0.025) on
treatment of Pulmonary TB on intervention group compared to a control group (p = > 0.05). Conclusions: It is
found an influence of health promotion upon one’s attitudes (knowledge, behave, and action) for preventive and
treatment Pulmonary TB on prisons available in Medan.
Keywords: health promotion, behavior, pulmonary TB

I. Introduction
The infectious disease is one of diseases recognized serious to threat the health over the world, found a highly
rate of illness and death due to the diseases, particularly on HIV/AIDS, malaria and Pulmonary Tuberculosis.
This such diseases has been the main priority in agenda available on the Millenium Development Goals (MDGs)
of 2015 under points : Kementerian Kesehatan REPUBLIK INDONESIA, (Direktorat Jenderal Pengendalian
Penyakit dan Penyehatan Lingkungan. 2011). Based on a report by World Health Organization (WHO) of 2012,
noted that Southeast Asia region constitute a region with the highest cases on Pulmonary TB approached 40% .
(WHO 2012) Indonesia is on the fifth rank with prevalence in 289 per 100,000 residents. (Dinas Kesehatan
Provinsi Sumatera Utara, 2012) Under a Health Profile of Sumatera Utara Province in 2012 found newly cases
of Pulmonary TB (+) on 14,302 people (68,86%) (Dinas Kesehatan Provinsi Sumatera Utara, 2012).
Pulmonary TB prevalence also contribute sourced residents at public places, especially in the
correctional facility (Lapas), because it has a great potential and facilitate the onset of TB infection because the
length and the major exposure to Mycobacterium, and mentioned also that new infection risk factor gets TB or
latent TB reactivity of infector as a poor nutritional status and physical and emotional pressures also inmates.
The occurrence of TB in prisons is usually reported to be much higher than the average rate reported in
public.TB was reported as the most common cause of death in prisons located in developing countries. High
number of incident TB inmates at the prison caused by comparison of the room is not proportionate to the
occupants, coupled with the prisoners who come from groups who are already at high risk population is infected
with TB. In addition, prison setting based on characteristic crime rather than on his health could increase the
transmission or the transmission of TB, the detection of cases of late, and inadequate treatment will cause a high
risk of prisoners infected with TB (Bausanno, 2010). In addition the prison is the reservoir for the transmission
of the disease to the public at large through the prison staff, visitors, and close contact with prisoners being freed.
Transmission dynamics between prisoners and the general public play a key role in encouraging the incidence of
TB in the community as a whole. Therefore needed a way to prevent and control TB in prisons (Niveau, 2006).
According to Health RI (2012), the potential transmission of Pulmonary TB in Lapas are very high, because
most of the residents have exceeded the capacity of prison, results of the study showed the prevalence of
pulmonary Tuberculosis on the residents in the region of rutan/Lapas Jabotabek is 7.5 times greater than the
general population. The research of Manzoor, et.al. (2009) the Jailbird in Pakistan, explaining that pulmonary
TB cases also occur in penguni prison, from 261 samples there were 9.2% positive prison inmates suffer from
pulmonary TB, 5.7% of whom had a history of Pulmonary TB in the family, 18.3% had symptoms of cough of

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Vol.6, No.10, 2016

more than Sunday.

An official Report of Provincial Law and Human Rights Affairs of Sumatera Utara (2012), stated for a
period 3 (three) years such 2009-2011, a fluctuation cases of Pulmonary TB on those prisoners found.
(Direktorat Jenderal Pemasyarakatan Departemen Hukum dan Hak Asasi Manusia RI, 2012). A phenomenon
newly cases of Pulmonary TB on those prisoners tends increasing up, to this matter should be attention by
prisoner authority in order to prevent and overcome the infectious of Pulmonary TB on those prisoners, it is
referred to government policy and under action plan to realize, so it is highly required a new strategic with more
effective and efficiently how to prevent Pulmonary TB as the following strategic; Kementerian Kesehatan
REPUBLIK INDONESIA. Controlling straight even eradicating Pulmonary TB on those prisoners, provide with
a special session counseling and health promotion, (World Health Organization. Global Tuberculosis Report
2013). since one factor to contribute existed a pulmonary TB is lacking behave by individual on health. Health
promotion on Prisoners may adopt media such as routine counseling specifically to those new prisons, also with
media leaflet and brochures, with other technical way as well as.
Health promotion is expected to enhance the understanding of the residents of prison generally about
health and specifically about the countermeasures of pulmonary TB. This is because the knowledge factor of
sufferers is one of the most influential risk factors. The lack of knowledge about how the prevention and
eradication of TB of the lungs that is does not know how to meminun the drug, how to prevent transmission by
not spitting in haphazard places, keep clean themselves, closing the mouth at a time when cough and other
actions. Sufferers lack knowledge allegedly due to lack of information regarding Pulmonary TB. State of
knowledge is lacking due to the attitude of sufferers don't want to know and ultimately highly influential action
against sufferers against the efforts of prevention and eradication.
Based on a prior medan survey held on September 2011 showed that on Prisoner Grade I out 44
prisoners with positive.
Pulmonary TB majority behaved in high risk against infectious Pulmonary TB over other prisoners, do
spitting in any place also do bad behaved that able to aggravate incidental Pulmonary TB such as smoking and
got sleeping late night.
The initial results of the survey also described penanangan nutritional problems in prisoners inmates in
prisoners grade 1 still do not meet nutritional needs required for the person who has Pulmonary TB disease, there
is no distinction regarding the fulfillment of nutrition on a group of people who are infected with TB and
Pulmonary TB uninfected (healthy). For the management of pulmonary TB sufferers in intensive phase, the diet
needs to be given is High Energy diet which is rich in Protein (WOULD), with the goal of diet to meet the needs
of energy and proteins which greatly improved so as to prevent and reduce damage to the tissues of the body and
put on weight to achieve a normal weight (Martony, 2006). Diet in accordance with the rules of granting of a
disease afflicting residents of prison noteworthy, because food is one of the factors that help the acceleration the
healing of diseases in the person who suffers.
In addition in prisoners grade I also there is no isolation room that should exist in order to avoid the
transmission of diseases through air circulation that is in the custody room. Procurement of spaces of isolation
required due to Pulmonary TB transmission through coughing or sneezing, sufferers who spread germs into the
air in the form of droplets (a splash of phlegm). Droplets containing germs can survive in air at room
temperature for a few hours, a person can be infected if the droplets inhaled into the respiratory tract. A cough
from a Pulmonary TB sufferer can produce 3000 droplets nuclei (Musadad, 2006). Power transmission from a
Pulmonary TB sufferer is determined by the number of germs exhaled. The higher the degree of positive sputum
examination results, then the more contagious disease sufferers are. Thus, the merger of prisoners suffering from
TB of the lungs with a healthy prisoner is one of the factors that speed up the process of transmission, it is one of
the causes of the difficulty of lowering the number of pulmonary TB sufferers in prison. In addition to air
circulation, so the lighting in the space of prisoners is still lacking. Pulmonary TB germs can survive in the
dark/humidity within a few hours, but direct sunlight can quickly kill them
Based on the curative aspect, unknown treatment strategy for patients with pulmonary TB on inmates
tend to have not a healing oriented perfectly, it indicated the presence of positive Pulmonary TB inmates who
drop out of treatment process with percentage of 1%, and the absence of effort monitoring the evaluative against
so cannot be identified the level of Pulmonary TUBERCULOSIS cure coverage on inmates. Short interview with
6 (six)-positive pulmonary TB inmates, the majority (78,2%) stated do not take medication on time, and say
there is no overall oversight of prisoner officer against the continuity of treatment. In general the success of
pulmonary TB treatment is determined by the Supervisory role of the Swallow drugs (PMO).
Prison management has done a variety of efforts to lower the number of pulmonary TB in pain for
inmates, through the efforts of prevention and countermeasures of pulmonary TB in prison, as recommended by
Health RI. These efforts include the transmission of pulmonary TB prevention efforts on inmates, increased
knowledge and healthy lifestyle behaviors for inmates through the extension of health, nutrition, as well as
setting treatment efforts on schedule drug for patients with positive Pulmonary TB

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2. Material And Methods

2.1 types of Research
This type of research is quasi experiment (experiment of the artificial) that aims to explain the influence of
health promotion behavior towards prevention and treatment of pulmonary Tuberculosis. This research was
conducted against the two groups, the intervention and control. The intervention group was a group of inmates
who are in Lapas grade 1 prisoners whereas the control group is the Group of inmates at Prisoners grade I
Medan.

2.2 Population
The population in this study are divided into two groups, the Group of healthy inmates (not suffering from
Pulmonary TB) and a group of inmates are ill (suffering from Pulmonary TB). The population of inmates who
are referred here is the research group for the prevention of pulmonary TB, while the convict population ill
(suffering from Pulmonary TB) is a research group for the treatment of Pulmonary Tuberculosis.
As for healthy prisoners of grade 1 Medan (not suffering from Pulmonary TB) numbering is known as
1,507 people. The number of inmates is divided into three (3) blocks, whereas in class I Rutan Terrain that is as
much as 1,646 people divided into 9 (nine) block. While inmates who suffer from Pulmonary TB in Lapas class I
Field numbering 60 people, but prior to intervention 2 inmates had free, so there is no prisoners whom are not
included in this research so that the number of TB sufferers are examined as many as 58 people and inmates who
suffer from Pulmonary TB in Prisons as many as 58 Field class I people.

2.3 Samples
This research was conducted on 2 (two) groups namely an intervention and control. On the intervention group
total sample of each intervention group and control noted 158 people. On the treatment group, total sample of
each group of intervention and control noted 58 people. The data obtained by questionnaires that has been
distributed before and after doing a health promotion.

2.4 Data Collection

Analyze the data by looking at the relationship between the two variables (independent and dependent) by
examining the dependent, i.e. measuring the difference in the results of the knowledge, attitudes and actions of
prevention and treatment of pulmonary Tuberculosis before (pre-test) and after (post-test) conducted intervention
at both the intervention group or a control group.

2.5 interventions
Based on the framework of theory and research purposes such as those described above, the framework of the
concept of research as follows:
Health promotion
Early behavior:
1. Knowladge
Group: 2. Attitute
1. healthy inmates 3. Action
2. sick inmates
Prison grade 1
(Intervention) Last behavior:
1. Knowladge
2. Attitute
Age 3. Action
Education
Marital status Early behavior:
1. Knowladge
2. Attitute
Rutan grade 1
3. Action
(control)
Early behavior:
1. Knowladge
2. Attitute
3. Action
Figure 1.6 the framework concept of Research

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In this study then the prisoners were divided into two groups, the prisoners are healthy as Pulmonary
TB prevention research samples, and inmates are sick as Pulmonary TB treatment research samples. Each
sample represents population groups from grade 1 prisoners and grade I Rutan Medan . Then do the initial
measurements using instruments of the research which has been prepared concerning the knowledge, attitudes
and actions of inmates against Pulmonary TB treatment or prevention, at both the samples in prison and Rutan
grade 1 Medan. After initial measurement results obtained then performed with the model of health promotion
interventions are effective and efficient, the only intervention carried out on the sample in prison grade I Medan.
After implementing the intervention then performed again measurement to knowledge, attitudes and actions of
the respondent (the measurement of end).

3. Results
3.1 Characteristics of the intervention group Equality Analysis and control On the prevention of Pulmonary TB
Table 1 :
Frequency distribution analysis of the equivalence of the characteristics of the intervention group and the control
in the prevention of Pulmonary TB
a Age Intervention group Control group p
N % N %
1 Young Adults 59 37.3 67 42.4
2 late adulthood 99 62.7 91 57.6 0,613
Total 158 100.0 158 100.0
b Marital Status
1 Kawin 109 69.0 121 76.6
2 Tidak Kawin 49 31.0 37 23.4 0,992
Total 158 100.0 158 100.0
c Education
1 Low 96 60.8 92 58.2
2 Middle & High 62 39.2 66 41.8 0,597
Total 158 100.0 158 100.0
d Work
1 Yes 118 74.7 109 69.0
2 no 40 25.3 49 31.0 0,105
Total 158 100.0 158 100.0
In table 3.1 above obtained research results as follows:
1. There is a difference in the percentage of respondents age between intervention and control groups in the
prevention of pulmonary TB, where age young adults in the intervention group (37.5%) and in the control group
(42,4%), whereas age adults continued in the intervention group (62.7%), and in the control group (36%). Based
on test results obtained p value chisquare > 0.05 which means there is no difference among respondents age
significantly the intervention group and the control group on the prevention of TB , meaning that the age in both
groups are equivalent.
2. There is a difference in percentage of marital status between the control and intervention groups in the
prevention of pulmonary TB, where respondents who married in the intervention group (69,0%) and in the
control group (76,6%), while respondents who did not mate in the intervention group (31,0%), and in the control
group (23.4%). Based on test results obtained p value chisquare > 0.05 which means there is no significant
difference in marital status of respondents among the intervention group and the control group on the prevention
of TB, meaning that the marital status on the two groups was equal.
3. There is a difference in the percentage of educated respondents between intervention and control groups in the
prevention of pulmonary TB, where education is lower in the intervention group (60,8%) and in the control
group (58,2%), whereas secondary education + high in the intervention group (1%), and in the control group
(41.8%). Based on test results obtained p value chisquare > 0.05 which means there is no distinct differences
between the respondent's education significantly the intervention group and the control group on the prevention
of TB , meaning that the education on the two groups was equal.
4. There is a difference in the percentage of respondents work between intervention and control groups in the
prevention of pulmonary TB, where respondents who work in the intervention group (74.7%) and in the control
group (69,0%), while respondents who do not work in the intervention group (25.3%), and in the control group
(31,0%). Based on test results obtained p value chisquare > 0.05 which means there is no distinction between the
respondent's work significantly the intervention group and the control group on the prevention of TB of the lungs,
meaning that the work on the two groups was equal.

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3.2 Analysis of the equivalence of the characteristics of the intervention group and the control On the treatment
of Pulmonary Tuberculosis
Table 2
Frequency distribution analysis of the equivalence of the characteristics of the intervention group and the control
On the treatment of Pulmonary Tuberculosis
a Age Intervensi Kontrol P
N % N %
1 Young Adults 42 72.4 20 34.5
2 late adulthood 16 27.6 38 65.5 0,991
Total 58 100.0 58 100.0
b Marital Status
1 Kawin 44 75.9 38 65.5
2 Tidak Kawin 14 24.1 20 34.5 0,280
Total 58 100.0 58 100.0
c Education
1 Low 28 48.3 24 41.4
2 Middle & High 30 51.7 34 58.6 0,567
Total 58 100.0 58 100.0
d Work
1 Yes 37 63.8 42 72.4
2 no 21 36.2 16 27.6 1,000
Total 58 100.0 58 100.0
n table 3.2. the above results are obtained as follows:
1. There is a difference in the percentage of respondents age between intervention and control groups on the
treatment of pulmonary Tuberculosis, where the young adult in the intervention group (72,4%) and in the control
group (34.5%), whereas aged adults continued in the intervention group (27.6%), and in the control group
(65,5%). Based on test results obtained p value chisquare > 0.05 which means there is no difference among
respondents age significantly the intervention group and the control group on pulmonary TB treatment, meaning
that age in both groups are equivalent.
2. There is a difference in percentage marital status between the intervention and control groups on the treatment
of pulmonary Tuberculosis, where respondents who married in the intervention group (75.9%) and in the control
group (65,5%), while respondents who did not mate in the intervention group (24.1%), and in the control group
(34.5%). Based on test results obtained p value chisquare > 0.05 which means there is no significant difference
in marital status of respondents among the intervention group and the control group on the treatment of
pulmonary Tuberculosis, it means that the status of marriage in the two groups were equivalent.
3. There is a difference in the percentage of educated respondents between intervention and control groups on
the treatment of pulmonary Tuberculosis, where education is lower in the intervention group (48.3%) and in the
control group (41.4%), whereas secondary education + high in the intervention group (51,7%), and in the control
group (58.6%). Based on test results obtained p value chisquare > 0.05 which means there is no distinction
between the respondent's education significantly the intervention group and the control group on the treatment of
pulmonary TUBERCULOSIS, it means that education on the two groups was equal.
4. There is a difference in the percentage of respondents work between intervention and control groups on the
treatment of pulmonary Tuberculosis, where respondents who work in the intervention group (63.8%) and in the
control group (72,4%), while respondents who do not work in the intervention group (36.2%), and in the control
group (27.6%). Based on test results obtained p value chisquare > 0.05 which means there is no distinction
between the respondent's work significantly the intervention group and the control group on pulmonary TB
treatment, meaning that the work on the two groups was equal.

3.3 The Affect Of Health Promotion On Behave In Prevention Pulmonary Tb On The Intervention And Control
Group
Respondent on the preventive Pulmonary TB refers to age group almost on intervention and control group in >
30 years old; respectively 39.0% and 57.6%. Respondent on a treatment of Pulmonary TB refers to their age
group almost in intervention group of 17-30 years old noted 45.0% and on control group aged 30 years old >
note 40.7%. Their behave on prevention Pulmonary TB is measured refers to the knowledge, attitude and their
action. The result by statistics test is seen in Table 3.

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Table 3.
The Affect Of Health Promotion On Behave In Prevention Pulmonary Tb On The Intervention And Control
Group
Remarks Mean Different p
Mean
Pretest Postest
Knowledge
a. Intervention 5,63 8,23 2,6 0,004
b. Control 6,03 5,90 -0,13 0,543
Attitude
a. Intervention 20,16 22,53 2,37 0,000
b. Control 22,20 21,56 -0,64 0,160
Actions
a. Intervention 5,15 7,94 2,79 0,000
b. Control 5,78 5,69 -0.09 0,627
On Table 3 above indicated that there is significant different increased up their knowledge on
prevention Pulmonary TB between the group of intervention and control. On the intervention group, found
significantly increased average score of knowledge about the preventive Pulmonary TB where the noted p < 0,05
value, while on control group there is no found significantly increasing average score of their knowledge on
preventive Pulmonary TB where its value p > 0,05. This result indicated that the role of a health promotion is
highly required in order to prevent Pulmonary TB on Prisons.
To behave by treatment to Pulmonary TB was measured according to their knowledge, behave and
action as respondent with Pulmonary TB. The results of statistic test can be seen on Table 2.
Table 2. The Influence Of Health Promotion On Behave With Different
Treatmen Pulmonary Tb On Intervention And Control Mean Mean P
GroupRemarks
Pretest Post
test
Knowledge
Intervention 5,95 8,40 2,45 0,017
Control 5,72 1,55 4,17 0,190
Behave
Intervention 21,07 23,19 2.12 0,000
Control 21,28 1,62 19.66 0,110
Action
Intervention 6,28 8,91 2.63 0,025
Control 5,93 1,57 4,36 0,090
Based on the results indicated that there is different increasing up their knowledge found about
treatment to Pulmonary TB between intervention and control group. On the intervention group, there is
significant increasing average score of knowledge on treatment Pulmonary TB noted where p value < 0.05, while
on control group, there is no significant increasing average score found on their knowledge of treatment
Pulmonary TB where p value > 0.05. The result of analysis showed that health promotion surely affect to an
increasing their knowledge to treatment Pulmonary TB found on Prison Grade I of Medan.

3.4 The Intervention

3.4.1 Empowerment
1. Pulmonary TB Prevention Counselling On Healthy Inmates
Research is done in two groups, on the extension of
Prevention of pulmonary Tuberculosis for healthy inmates and guidance about the treatment of pulmonary
TUBERCULOSIS on pulmonary TB sufferer . Counseling regarding prevention of pulmonary TB is carried out
twice a week on Mondays and Wednesdays at 10:00 a.m until 10.30 pm. Selected starting at 10.00 am because in
these hours is the free time or time where prisoners have no activities, so all the prisoners can attend our research
without interference from other activities. The selection of 30 minutes within each extension is a pretty effective
being done because the topics presented are not too dense, with the aim that the prisoners will be able to
understand each topic presented well and not feel bored with the topic presented.
The duration of the extension of pulmonary TB prevention for healthy inmates and counseling about
treatment of pulmonary TB for prisoners who had suffered pulmonary TB is done for 4 months means, there are

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32 times of meeting.research conducted by researchers every week in the meeting accompanied by prisoners
who have been trained (health cadres), level II health service, section of prevention of contagious disease, and
NGOs FHI (Family health International).. Researchers also assisted from the nursing staff from lapas and staff of
mentoring community (Civic Guidance Lapas 1 Medan). Every activity performed in the Hall extension lapas.
The results obtained in the first week that is there is no difficulty in gathering the participants, either in
the healthy inmates or convict participants who had suffered pulmonary TB. The absence of trouble because
participants are always in the same area so it's easy enough to invite them, although at first there is the
impression of forcing them to be present in the meeting, this occurs at the first meeting on prevention of
pulmonary TB in prisoners healthy. This occurs because they feel the prevention pulmonary Tb is not important
for them, because their knowledge regarding pulmonary TB is very low, so they are not aware of the risk of
exposure to TB bacteria is very large especially on correctional prison grade 1 location. Low knowledge
obtained as a result of pre-test prior to the extension.
Topics presented in pulmonary TB prevention counselling consists of self hygiene, maintaining the
cleanliness of the bathroom, the cleanliness of the bed, the agent of transmission of pulmonary TB causes,
symptoms of contracting pulmonary TB, pulmonary TB transmission media, the way of transmission of
pulmonary TB, infectious pulmonary TB time duration, keep the hygiene of prisoners, keeping air circulation by
drying equipment, sleep, avoid contact, use of old equipment bedding, tableware , drinking equipment. Each
topic will be repeated again at a subsequent meeting before going into a new topic. Going on the increase and
decrease in the participation of pulmonary TB prevention counseling participants. At the beginning participation
advising inmates still less active, but as time went on participation of inmates are becoming more active and on
certain phases of fall back and active again. This is because the topics discussed at the research prevention
pulmonary TB, the inmates have yet to feel the symptoms of pulmonary TB disease. If the decline in
participation occurs, the liveliness and the seriousness of the inmates in listening, researchers will more actively
asking the opinion of the inmates on the topic that is being disscused.
Setting position places the participants done like extension customarily is generally where the position
of the extension officers in front of participants sit on a Chair. The media used are the props of pulmonary TB
Director P3L and loudspeakers. during the process of counseling, researchers also distributed leaflets relating to
prevention of pulmonary TB. Pulmonary TB prevention leaflet contains information what is a pulmonary TB,
what are the symptoms of pulmonary Tuberculosis, and how to prevent a pulmonary TB .
The results obtained after intervention of the occurrence of changes in knowledge, attitudes, and actions
of healthy inmates in preventing transmission of pulmonary TB. Changes in knowledge, attitudes and actions of
inmates seen increased votes based on the results of the pre-test that compared to the results of a post-test.
Knowledge of inmate most increase was about a prolonged cough, phlegm so long as well as cough and bleed
more than two weeks are symptoms of early onset of pulmonary TB. Prior to intervention if there are symptoms
such as cough, phlegm so prolonged and bloody and long cough more than two weeks they presume that they
cough is a cough. At the beginning, prisoners
The results obtained after intervention of the occurrence of changes in knowledge, attitudes, and actions
of healthy inmates in preventing transmission of pulmonary TB. Changes in knowledge, attitudes and actions of
inmates seen increased based on the results of the pre-test that compared to the results of a post-test. Knowledge
of inmate most increase was about a prolonged cough, phlegm so long as well as cough and bleed more than two
weeks are symptoms of early onset of pulmonary TB. Prior to intervention if there are symptoms such as cough,
phlegm so prolonged and bloody and long coughing more than two weeks they presume that the cough is
normal. At the beginning, prisoners less knowing that bacteria like microbacterium on a humid and the germs
will die on air that getting the exposure or sufficient lighting from sunlight, but after the intervention of inmates
already know it. The attitude of inmates also undergo changes. The change in attitude that is keeping the contact
or direct relationship with pulmonary TB sufferer can prevent contracting pulmonary TB, prior intervention is
never healthy inmates maintain contact with inmates who are experiencing symptoms of pulmonary Tuberculosis.
Healthy inmates also experienced a significant change in attitude about keeping the air circulation in the room of
inmates also can be a source of transmission of pulmonary Tb. The action is the most experienced changes
namely seen inmates began to shut their mouths if any of his friends who are sneezing, drying equipment of the
bed to keep it moist, and the increasing inmates doing a consultation with a health worker at the moment of
experiencing health problems, especially in the case of a cough that is not healed up to 1 week.
2. Pulmonary TB Treatment Counseling on Healthy Inmates
Guidance on the treatment of pulmonary Tuberculosis on inmates who suffer from pulmonary TB is carried out
twice a week on Tuesdays and Thursdays at 10:00 a.m until 10.30 pm. Selected starting at 10.00 am because at
this time is free time or time where inmates no activity and the hours inmates are already getting breakfast so
expect all prisoners can attend counseling and not disturb other activities. Election time is 30 minutes in every
extension is quite effective being done because of the topics submitted TB treatment pulmonary tetntang is not
too dense, with the aim of inmates will be able to understand every topic treatment pulmonary TB are delivered

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Vol.6, No.10, 2016

with a good and not feel bored with the topic presented.
Different phenomena obtained on inmates who suffer from pulmonary TB in following pulmonary TB
treatment counselling. The prisoners who had suffered pulmonary TB more enthusiastic to follow the guidance
of treatment of pulmonary TUBERCULOSIS. At the beginning of their penyuluhanpun tuned properly on any
topic that is described, this may be due the participants felt that education on pulmonary TB treatment is the need
for them to heal faster from pulmonary TB disease. The atmosphere at the beginning of the meeting already
occurred between the liveliness of the researchers as extension officers with inmates who suffer from pulmonary
TB. The number of participants who hadirpun as expected i.e. as many as 58 people. Some participants also
widely consulted regarding pulmonary TB that they suffered, and many are asking why they can suffer from
pulmonary TB, so 30 minutes provided seemed still lacking.
Topics presented on pulmonary TB treatment extension consists of the stages of the treatment of
pulmonary TB sufferers, the early stages of the treatment of pulmonary Tuberculosis, pulmonary TB diagnosis
duration, type of pulmonary TB, the duration of the time failed to take medication, duration of treatment, the
recurrence of pulmonary TB sufferers, the schedule of medication per day, stopped taking the drug, the
consequences and the use of antibiotics. Each topic will be repeated again at a subsequent meeting or the topics
at a meeting previously unfinished delivered can be resumed at the next meeting because participants on
pulmonary TB treatment counseling more actively consulted. On inmates who suffer from pulmonary TB are
paying counseling about treatment of pulmonary TB also increase and decrease participation though not so
visible, such as inmates who follow the pulmonary Tuberculosis prevention counseling.
Setting position places the participants done like extension customarily is generally where the position
of the extension officers in front of participants sit on a Chair. The media used are the props of pulmonary TB
Director P3L and loudspeakers. during the process of counseling, researchers also distributed leaflets relating to
the treatment of pulmonary TUBERCULOSIS. pulmonary TB treatment leaflet shows how to treat pulmonary
TB, what happens if I stop taking the drugs prematurely, TB and how the transmission of TB.
The results obtained after intervens
3.4.2 Installation of Banners in Lapas and Posters inside the Block Lapas
Installation of the banner is placed at the place often traversed and easily read by convicts and also officer in
Lapas didinding at the entrance block lapas. Banners obtained from NGO FHI good design they form as well as
the content of the messages about pulmonary Tuberculosis. Banners provided there are the first two contain lets
share Info Pulmonary TB in Tanjung Gusta lapas. This writing contains the call to all citizens, both convicts or
lapas officers working in Lapas for sharing information about pulmonary Tuberculosis for the inmates who have
not been infected with TB of the lungs can prevent transmission of pulmonary TB and also for inmates who have
been infected can be reminded, for regularly taking medication. The second banner containing tuberculosis
symptoms include cough phlegm so for 2 weeks, coughing, coughing blood mixed up to chest pain, cold sweats
at night even without activities, hectic fever and more than 1 month. On the banners were also mentioned if the
convicts and the health workers are experiencing those things above, so can segesra be informed of the health
cadres, head to the room or directly visit the doctor doctor or health worker to obtain examination and treatment.
The banner is one of the media that are easily created and placed in a public place so that it is readable by
everyone. Banner-the banner is expected to be a source of information and tools to bear in mind the convicts and
the officers regarding pulmonary TB lapas. The posters taped on the walls in residential blocks. The content of
the posters is closing the mouth when coughing and sneezing and described how close the mouth while sneezing.
It is useful to remind the inmates and officers lapas 90,000 TB.
3.4.3 Social Support
Social support in health promotion interventions conducted by administering the extension and training to the
lapas. This is done to enhance the knowledge, attitude and practice of the officers regarding the prevention and
treatment of pulmonary TUBERCULOSIS. Granting the intervention to the lapas because officers lapas is one
high-risk suffered pulmonary TB. Extension and training carried out twice for 4 months. The selected day when
doing outreach and training is Friday, because on Friday the officers Lapas not too many activities can be done
so that the extension and training during their activities i.e. precisely 14.00 to 15.30 GMT. At the first meeting
discussed about the prevention of pulmonary TB and the last meeting regarding the treatment of pulmonary
Tuberculosis. The quantity of the extension and the training is not enough too much once in 2 months and
expected with a short time does not affect the quality of the giving of the information, because the officers have
often followed the training so easy enough for them to absorb information properly.
Extension and training conducted in the Hall lapas and organized by the Department of health and
doctors Lapas. First performed, namely the introduction of health workers sent from the Department of Health to
provide guidance and training on pulmonary TB. Officials from the Department of Health stated that he was very
berantusias in this activity, because the extension and training of pulmonary TB is very necessary the Lapas,
because Lapas is at high risk of transmission of TB in the lungs. Humid places, a room which filled with inmates
who are didalammya filled with convicts coupled with hygiene is lacking to make a most Lapas are at risk of

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transmission of pulmonary Tb. Parties at high risk for pulmonary TB-infected inmates not only alone but could
also be about the officers who were on duty supervising Lapas inmates. The officers who do not understand
about pulmonary TB will mengangabaikan the inmates were suffering from coughs and talk to them without the
thought that inmates suffered not cough cough is common, but because it suffers from pulmonary TB,
pulmonary TB germs so that they also will be suffered by officer Lapas due to contracting TB sufferers in lapas
inmates. The most dangerous thing if the officers suffering from pulmonary TB Lapas can pass the disease to
other employees, inmates and their families, which can lead to a family that their loved one will also suffer from
pulmonary TB. Therefore he asserted to the officers must follow the Lapas with serious, focused and thorough
guidance and training regarding prevention and treatment of pulmonary TB are only done twice. That's how the
phrase was first conducted of health service officers as the beginning of her relationship to the officers Lapas.
The response obtained from the officers Lapas are excellent, they listened to seriously and listen
carefully, the extension and the training of the health service which assisted by doctor lapas, such activities are
not too rigid but remains in a State of serious. Some questions are also leveled by the officers they asked for
example Lapas symptoms of pulmonary Tuberculosis, the leading cause of pulmonary TB incidence,
transmission, how do I do just by talking with pulmonary TB sufferer can cause us contracting pulmonary TB.
That's the core question raised by officers at the first meeting with Lapas topic discussion of prevention of
pulmonary TB. Training is also conducted by practicing preventive measures such as pulmonary TB how do I
close my mouth when coughing and spitting don't in any place
The second meeting was conducted on the same day i.e. Friday at 14:00 pm to 3.30 pm, at the second
meeting of the extension and training is also done from the health service. The topic regarding the treatment of
pulmonary Tuberculosis, which consists of pulmonary TB treatment ways and what happens if I stop taking the
drugs prematurely. It was first performed at the second meeting was reminded the officers regarding the
prevention of pulmonary TB Lapas, afterwards he asks whether there are health workers who have experienced
pulmonary TB and obtained that none of the officers stating Lapas suffered pulmonary TB. Lo lung TB
treatment in training officers Lapas aims to increase the role and the attendant Lapas to be trustees taking
medication for inmates who suffer from pulmonary TB. In achieving the healing of pulmonary TB patients on
prisoners is not enough with the support that comes from of their own, but also need support from people who
were, among others, support the existing dilapas health workers including the support of the clerk Lapas. After
the extension and training in harapakan officer Lapas can give attention to pulmonary TB sufferers in reminding
the mengkosumsi of the drug on a regular basis. He also explains the healing of inmates not only
mengguntungkan for sufferers, but for others who were officers, including Lapas.
The response from the officer Lapas are good enough, but if compared with the topic prevention of
pulmonary TB, the response from the officer lapas little decline in terms of listening than on the topic of the
treatment of pulmonary TUBERCULOSIS. This is because the officers never suffer lung TB so that their
curiosity is lower and because also it is not very important to them. At the end of the meeting of officials from
the Department of Health stated that giving information about pulmonary TUBERCULOSIS to the Lapas is the
beginning of great changes that can serve as a source of information about health care primarily about pulmonary
Tuberculosis for themselves and inmates. He gave a message to the Clerk to continue considering the lapas and
practice the things related to pulmonary TB and is expected to be able to share information regarding pulmonary
TB to colleague and also to the inmates who will be on successive Lapas.
The results obtained on the social support is the occurrence of behavior change officer lapas e.g. remind
for inmates who experienced coughing more than a week for medical treatment to the clinic lapas, then remind
the inmates who suffer from pulmonary TB to not throw the saliva carelessly and close the mouth when
coughing. To healthy inmates suggested a health officer for not too long contact with pulmonary TB sufferers.
3.4.4 Advocacy
Advocacy in this regard is the tangible form and commitment. Advocacy done to Head Lapas and health
service/sexy P2M. The purpose of advocating to Kalapas i.e. can provide support, direction and mengasilkan
policies, while in health services can provide support to the Lapas penaggulangan in prevention and treatment of
pulmonary Tuberculosis.
Advocacy done to Kalapas starts with asking for support in tackling pulmonary TB, after going through
a fairly long discussion, response from Kalapas is excellent and will help completely, whatever is needed in
tackling pulmonary TB. Then the diajukanlah petition for pembetukan Team Penaggulangan TB. Finally the
meeting was undertaken in shaping the team Penaggulangan TB. Trees talk in meetings, preparation of the
position and the duties and responsibilities of each position holders and ultimately resulting in Team
Penaggulangan TB Dots Strategy in Lapas with Klas I Medan signed by Kalapas (Ajub Suratman, Bc. IP. Spd.
Msi). This formation is a form letter of commitment from the leadership of the Lapas penaggulanagan in
prevention and treatment of pulmonary Tuberculosis in Lapas. Don't stop at just policy but also permit the
creation of spaces Kalapas isolation for patients with pulmonary TUBERCULOSIS in Lapas.
Team Penaggulangan TB Dots Strategy in Lapas with Klas I Field aims to lower the number of

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pulmonary TB sufferer's pain. Position in the team for tackling inter alia an adviser, in charge of implementing,
Chairman, managing enforcement screening, diagnosis, treatment and record keeping, pelapotan and IEC.
Penaggung replied on duty is responsible for the implementation of programme P2 TB and implementing
evaluation and monitoring of the implementation of the activities. The Chairman is in charge of coordinating the
implementation of the program P2 strategy in TB DOTS and sets guidelines and procedures Service TB.
Implementing screening is in charge of monitoring the implementation of the screening. Diagnosis on duty carry
out enforcement Pelaksanan and coordinate all activities related to the enforcement of the diagnosis. The
treatment is in charge of ensuring the availability of drugs, monitor the regularity of pengobtan, and conduct an
evaluation of treatment outcomes. Record keeping, reporting and record-keeping procedures is in charge of
setting the KIE and reporting, responsible in the availability form, record keeping and reporting, implementation
of the IEC. The creation of spaces for patients with pulmonary TB isolation done to prevent transmission of
pulmonary TB and TB sufferers of lung compliance menggontrol in taking medication, is expected with the
unification of inmates who suffer from pulmonary TB can facilitate health workers to remind patients taking the
medication, since the layout of the isolation room not far from the clinic Lapas. At first the room is where the
prisoners and detainees have now been renovated into spaces redesigned the isolation of pulmonary TB sufferers.
Advocacy is committed to the health service/Sexy P2M dilakuakan by sending a letter to ask for help in the form
of permohan leafleat about prevention and treatment of pulmonary TB and requested medication OAT
simultaneously. The results obtained health services provide assistance in accordance with the submitted
application and remain sustainable.

4. Discussion
4.1 Influence of Health promotion on the knowledge of Tb prevention in prison and prisoner grade 1 Medan
Based on the results of the study indicate that there is a difference in increasing knowledge about the prevention
of pulmonary Tuberculosis between the intervention and control groups, in the intervention group an increase in
knowledge about the prevention of pulmonary TB meaning the value of p < 0.05, whereas in the control group
there is no increase in knowledge about the prevention of pulmonary TB meaning the value p > 0.05. This result
gives an overview of the role that health promotion is urgently needed in the Pulmonary Tuberculosis prevention
efforts in prison.
A person's knowledge about the prevention of TB can be improved by doing health promotion at
regular intervals. Based on the results of the study can also be seen that the increase in the average score of
knowledge about prevention of Pulmonary TB in the intervention group there is an increase in a significant way
in which the value of p < 0.05, whereas in the control group is not an increase in knowledge about the prevention
of pulmonary TB in a significant way in which the value of p > 0.05. The sharing of information about TB will
affect someone to try to do a range of precautions to avoid infection of the disease. It is accordingly stated Paul
(2010), namely TB patient has been given the information by health workers about TB, these patients are more
likely to worry about the transmission of TB germs to other people, family and friends around them, so as to
encourage them to complete the treatment of TB.

4.2. The influence of health promotion on the knowledge of Tb prevention in prison and prisoners grade 1
Medan
Based on the results of the study indicate that there is a difference in increasing knowledge about the prevention
of pulmonary TUBERCULOSIS between the intervention and control groups, in the intervention group an
increase in knowledge about the prevention of pulmonary TB meaning that the value of p < 0.05, whereas in the
control group there is no increase in knowledge about the prevention of pulmonary TB meaning that the value
p > 0.05. This result gives an overview of the role that health promotion is urgently needed in the Pulmonary
TUBERCULOSIS prevention efforts in prison.
A person's knowledge about the prevention of TB of the lungs can be improved by doing health
promotion at regular intervals. Based on the results of the study can also be seen that the increase in the average
score of knowledge about prevention of Pulmonary TB in the intervention group there is an increase in a
significant way in which the value of p < 0.05, whereas in the control group is not an increase in knowledge
about the prevention of pulmonary TB in a significant way in which the value of p > 0.05. The giving of
information about TB will affect someone trying to do a range of precautions to avoid infection of the disease. It
is accordingly stated Paul (2010), namely patient TB has been given the information by health workers about TB,
these patients are more likely to worry about the transmission of TB germs to other people, family and friends
around them, so as to encourage them to complete the treatment of TB.
Based on the results of the study can also be seen that the increase in average score attitude towards
prevention of pulmonary TB in the intervention group improved significantly where the value of p < 0.05,
whereas in the control group is not an increase in pulmonary TB prevention attitude toward significantly where
the value p > 0.05.

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The attitude of someone very determined by how large those individuals have the knowledge about the
disease. The attitude of the respondent has been given a promotion about the prevention of TB, it can only be
influenced by knowledge of the respondents indeed had increased but increased knowledge has not touched the
levels of analysis, synthesis, or even an evaluation ", so that the knowledge gained by the respondents have not
really strengthen the respondents to be able to specify a stance against Pulmonary TB prevention.

4.3. The influence of health promotion on the knowledge of Tb prevention in prison and prisoners grade 1
Medan
Based on the results of the study indicate that there is a difference in increasing knowledge about the prevention
of pulmonary TUBERCULOSIS between the intervention and control groups, in the intervention group an
increase in knowledge about the prevention of pulmonary TB meaning that the value of p < 0.05, whereas in the
control group there is no increase in knowledge about the prevention of pulmonary TB meaning that the value
p > 0.05. This result gives an overview of the role that health promotion is urgently needed in the Pulmonary
TUBERCULOSIS prevention efforts in prison.
A person's knowledge about the prevention of TB can be improved by doing health promotion at
regular intervals. Based on the results of the study can also be seen that the increase in the average score of
knowledge about prevention of Pulmonary TB in the intervention group there is an increase in a significant way
in which the value of p < 0.05, whereas in the control group is not an increase in knowledge about the prevention
of pulmonary TB in a significant way in which the value of p > 0.05. The giving of information about TB will
affect someone trying to do a range of precautions to avoid infection of the disease. It is accordingly stated Paul
(2010), namely patient TB has been given the information by health workers about TB, these patients are more
likely to worry about the transmission of TB germs to other people, family and friends around them, so as to
encourage them to complete the treatment of TB.
Based on the results of the study can also be seen that the increase in average score attitude towards
prevention of pulmonary TB in the intervention group improved significantly where the value of p < 0.05,
whereas in the control group is not an increase in pulmonary TB prevention attitude toward significantly where
the value p > 0.05.
The attitude of someone very determined by how large those individuals have the knowledge about the
disease. The attitude of the respondent has been given a promotion about the prevention of TB, it can only be
influenced by knowledge of the respondents indeed had increased but increased knowledge has not touched the
levels of analysis, synthesis, or even an evaluation ", so that the knowledge gained of the respondents have not
really strengthen the respondents to be able to specify a stance against Pulmonary TB prevention.

4.4 The influence of health promotion on the knowledge of Tb prevention in prison and prisoners grade 1 Medan
Based on the results of the study showed that there is a difference of pulmonary TB prevention action increased
between the intervention and control groups, in the intervention group an increase in pulmonary TB prevention
actions meaning that the value of p < 0.05, whereas in the control group is not an increase in pulmonary TB
prevention actions meaning that the value p > 0.05.
Based on the research results obtained average score that increased action against pulmonary TB
prevention in the intervention group there is an increase in a significant way in which the value of p < 0.05,
whereas in the control group there was no increase in pulmonary TB prevention measures against significantly
where the value p > 0.05.
This fact can provide a conclusion on the control group that the actions of the respondent has not
changed due to the absence of a stimulus is given in the form of health promotion. Notoadmodjo mentions that
the actual change in behavior can occur if the presence of a given stimulus in the form of health promotion.
Implementation of continuous promotion with several materials that continue to be developed along with the
development of prevention and treatment of Pulmonary Tuberculosis may affect the actions of the inmates in
preventing Pulmonary TB.
In theory the Blum stated that knowledge or cognitive domain is very important for the formation of
one's actions. In theory are explained also that the behavior is the second largest factor after the environmental
factors that affect the health of individuals or communities, so environmental factors is the first determining
factor of occurrence of individual behavior change. Therefore, in order to foster a public health intervention
against strategic behavior factors but should be similar with changes in environmental conditions so that the
changes are expected to occur properly.

4.5 Influence of health promotion on the knowledge of Tb prevention in prison and prisoners grade 1 Medan
Based on the results of the research indicate that there is a difference in increasing knowledge about the
treatment of pulmonary Tuberculosis between the intervention and control groups, in the intervention group an
increase in knowledge about the treatment of pulmonary Tuberculosis meaning that the value of p < 0.05,

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whereas in the control group there was no increase in knowledge about the treatment of pulmonary Tuberculosis
meaning that the value p > 0.05.
The results of the analysis show that health promotion give influence on the improvement of knowledge
of the treatment of pulmonary Tuberculosis in prisoner Grade 1 Medan. The influence of health promotion to
increased knowledge of the treatment of visible from getting him the prisoners who are in prison grade 1 Medan
early symptoms of pulmonary TB disease such as coughing more than a week, there are blood spots as well as a
prolonged cough.
Increased knowledge of pulmonary TB treatment on inmates also demonstrated knowledge of the
changes in treatment. In this study it was found that respondents know that in order for TB disease can be
resolved soon if they understand the stages in the treatment of Pulmonary Tuberculosis in intensive and
advanced.
Of health RI (2008) highlights that health promotion is not only the process of awarding public or
awareness and increasing public knowledge about health, but also accompanied the efforts facilitated the change
in behavior. Therefore the success of the pulmonary TB medication largely determined the regularity of
antituberculosis medication. This can be achieved if awareness about pulmonary TB to consume medication on
a regular basis through increasing the knowledge of TB about prevention and treatment of pulmonary
Tuberculosis. To increase pulmonary TB knowledge about the treatment of intensive TB and have the correct
information (promotion) about TB sufferers, in hopes it will happen through increasing knowledge about
pulmonary TB sufferers.
With regard to the results of research on Pulmonary TB treatment knowledge suggests that the change
of knowledge provided through health promotion knowledge changes followed by treatment. In this study it was
found that respondents know that in order for TB disease can be resolved soon if they understand the stages in
the treatment of Pulmonary Tuberculosis in intensive and advanced.
Based on the results of the study showed that the increase in the average score of knowledge about
treatment of Pulmonary Tuberculosis in the intervention group improved significantly where the value p < 0.05,
whereas in the control group is not an increase in knowledge about the treatment of pulmonary Tuberculosis in a
significant way in which the value of p > 0.05

4.6 Influence health promotion on the knowledge of Tb prevention in prison and prisoners grade 1 Medan
Based on the results of the study showed that there is a difference the increased pulmonary TB treatment against
the attitude between the intervention group and the control group improved attitudes towards intervention
treatment of pulmonary TB meaning that the value of p < 0.05, whereas in the control group is not an increase in
pulmonary TB treatment attitudes towards significantly where the value p > 0.05.
Based on the research results obtained that the average score against pulmonary TB treatment in the
intervention group there is an increase in a significant way in which the value of p < 0.05, whereas in the control
group there was no increase in pulmonary TB treatment attitudes towards significantly where the value p > 0.05.
The research is in line with the research conducted by the Helper (2011) in finding that the increase of
knowledge and attitudes about Pulmonary Tuberculosis has not been followed by the implementation of
precautionary measures of transmission of pulmonary TB disease. Different to those undergoing treatment, in
this study the factors outside of promotional factor affecting respondents to act better. It is said that the existence
of discrimination in the community about Pulmonary TB disease says that an infectious disease and so choose
not to get along or adjacent to the people who suffer from Pulmonary TB. Many acts of discrimination received
by the patients of pulmonary Tuberculosis. Most Pulmonary TB patients get discrimination by its neighbors be
avoided, not invited to speak without fear about the disease moved in and never be viewed in cynical by
neighbors around. So the promotion of Pulmonary TB to the community need to be done so that the public can
understand how should behave towards patients of pulmonary TB in its environment.
Paul (2010) in his research stating that giving of the information follows the patient's TB is done at
City Hospital in the United States affect the knowledge, the attitude and actions of the patient's TB so as to
influence them to receive treatment and complete treatment that they do. Therefore the public health system in
the United States have obligations provide clear information to groups of patients on treatment Pulmonary TB
(Paul, 2010). This we need to apply the system of health services in Indonesia, because of the quality of health
services is also influenced by the quality of health workers.
The role of health workers including community health workers, nurses, doctors, laboratory workers
and others against the promotion of treatment of TB is very important, therefore health workers must be
knowledgeable and have skills in all aspects of the treatment of TB (McRae, 2008). Behavior and quality of
skills in health workers is the key to success in promoting adherence to the treatment of TB.

4.7 The influence of health promotion on the knowledge of Tb prevention in prison and prisoners grade 1 Medan
Based on the results of the study showed that there is a difference the increased action against pulmonary TB

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treatment between the intervention group and the control group, on an increase in intervention treatment of
pulmonary TB action against significantly where the value of p < 0.05, whereas in the control group is not an
increase in pulmonary TB treatment action against significantly where the value p > 0.05.
According to Widjanarko (2006), the discovery of Pulmonary TB cases has increased each year since
the strategy of DOTS in earnest in 1995. The discovery of Pulmonary Tuberculosis with SMEAR positive as
much as 15.62% of Pulmonary TB specimens suspek 1626, numbers still healing 79,75%, and treatment dropout
found as much as 16%, as well as sufferers of negligent medical treatment as much as 21%. And, almost all of
the Pulmonary TB sufferers have a PMO, in which the patient's own family. Knowledge, attitude and practice of
a PMO is bad it will cause failure of Pulmonary TB treatment, because these treatments require quite a long time.
This is because the General cause of pulmonary TB germ that is acidic intracellular Mycobacterium tuberculosis.
Based on the results of the study can be seen that an increase in the average score of pulmonary TB
treatment against action on an increase in the intervention group were significantly where the value of p < 0.05,
whereas in the control group is not an increase in pulmonary TB treatment action against significantly where the
value p > 0.05.
Support of health workers is indeed very important in altering the action of pulmonary TB patients.
With the support of health workers through the giving of information will allow the TB patients can overcome
the misunderstanding about the ways of treatment of TB and overcome the barriers perceived by the patient
while TB treatment process (Paul, 2010). Pamela Orr (2010) through its research States that intervention to
remove barriers to patient compliance with TB is focused on the health care system and on the individual. On the
health care system needs to be done the therapy treatment and preventive therapy. On a personal level, an effort
that needs to be done is the development and sharing of knowledge and the planned treatment of TB, which
include scientific, health beliefs and actions. The quality of the relationship of health care providers and patients
is very important with the proceeds from the educational efforts that support compliance. The intervention is
being carried out using a methodology that is a lot of participation in the family partnership proved to be
associated with increased compliance to eat medicine on Pulmonary Tuberculosis patients.

5. Conclusion
1. preventive behaviour increases TB health in prison for residents:
a. knowledge of Pulmonary TB prevention class 1 terrain residents experienced an increase of 2.099
times compared with residents of Rutan class 1 terrain won't get health promotion interventions.
b. attitudes about prevention of pulmonary Tuberculosis resident Lapas class 1 Terrain experienced an
increase of 9.973 times compared with residents of Rutan class 1 terrain won't get health promotion
interventions.
c. Actions on prevention of pulmonary Tuberculosis resident Lapas class 1 Terrain experienced an
increase of 10.219 time compared with residents of Rutan class 1 terrain won't get health promotion
interventions.
2. increased behavior treatment of TB for residents who are sick: prison
a. knowledge of the treatment of Pulmonary Tuberculosis resident Lapas class 1 terrain experienced an
increase of 2.286 times compared with residents of Rutan class 1 terrain won't get promotion
intervention treatment of pulmonary Tuberculosis.
b. attitudes about treatment of pulmonary Tuberculosis resident Lapas class 1 Terrain experienced an
increase of 7.875 times compared with residents of Rutan class 1 terrain won't get promotion
intervention treatment of pulmonary Tuberculosis.
c. Action about the treatment of Pulmonary Tuberculosis resident Lapas class 1 terrain experienced an
increase of 6.220 times compared with residents of Rutan class 1 terrain won't get promotion
intervention treatment of pulmonary Tuberculosis

6. Suggestions
Based on the conclusions of the research, it can be recommended some suggestions here:
1. for the Ministry of Justice and human rights
a. need for monitoring the health of inmates across Indonesia especially in prison on infectious diseases
such as Pulmonary TB
b. is need for policy formation team tackling TB DOTS in each prison in Indonesia
c. need for policy making spaces of isolation for patients with Pulmonary TB, which is useful to break the
chains of transmission of Pulmonary TB for other inmates
2. To Lapas and Rutan class 1 Field
a. Need the application of policies for TACKLING the TB TEAM SK DOTS in Lapas and Rutan class 1
Terrain that has been published.
b. need continuous monitoring and screening on inmates who allegedly suffer from Pulmonary TB.

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c. need to maintain and increase the number of posters, banners, and leafleat about Pulmonary
TUBERCULOSIS prevention and information on residential blocks Lapas and Rutan.
d. health promotion has been done can be maintained and continued with other partnership with
institutions related to efforts in preventing and treating Pulmonary TB in Lapas class 1 terrain.
e. need for a commitment to maintain the policies that have been published about the prevention and
treatment of pulmonary TB natinya despite the changing dynamics of the turnover of the head of the
prison
3. health services
a. need to hold health promotion through research, delivery of leaflets, posters and regularly and
continuously on Pulmonary Tuberculosis
b. need to conduct training of pulmonary TB to the prisoners
c. need to do the visits of the monitoring and evaluation of Pulmonary TB sufferers
d. need to be consistent and continuous improvement in providing medication OATS
4. Academics
a. needs to be done further research and develop the variables associated with the wider research on
prevention and treatment of Pulmonary Tuberculosis in particular with regard to house prisoners.
b. need to be developed further policy analysis about the method of intervention is being done to prevent
and treat Pulmonary TB in Lapas and Rutan class 1 terrain and this method can be used as a reference
in that can be implemented at other prisons and prisoners.

7. References
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Systematic Review. PLoS Med 7(12).
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Martony, O.2006. Efektivitas Pengobatan Strategi DOTS dan Pemberian Telur Terhadap Penyembuhan dan
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McRae M, Taylor SJ, Swain L, Sheldrake C. 2008. Evaluation of a pharmacist-ed, medicines education program
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Ekologi Kesehatan. Vol. 5, No. 3, Desember 2006.
Pamela or 2010. Adherence to tubercolosis care in Canadian Aboriginal populations part 2: a comprehensive
approach to fostering adherent behavior. Kanada : Departments of Medicine, Medical Microbiology and
Community Health Sciences, University of Manitoba, Winnipeg.
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